Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS4476863 A
Publication typeGrant
Application numberUS 06/253,523
Publication dateOct 16, 1984
Filing dateMar 9, 1981
Priority dateMar 9, 1981
Fee statusLapsed
Publication number06253523, 253523, US 4476863 A, US 4476863A, US-A-4476863, US4476863 A, US4476863A
InventorsNikolai N. Kanshin, Igor A. Guskov, Alexei A. Konoplev, Alexandr E. Sachkov, Matvei M. Mats
Original AssigneeKanshin Nikolai N, Guskov Igor A, Konoplev Alexei A, Sachkov Alexandr E, Mats Matvei M
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Surgical instrument for establishing circular coloanastomoses
US 4476863 A
Abstract
The surgical instrument of the present invention is for establishing circular anastomoses between various segments of the colon.
The surgical instrument comprises a cylindrical body having a mandrel 2 at one of its ends and accommodating a coaxially arranged rod 3 carrying a circular knife 4 locked in place thereon and provided with a mechanism for its longitudinal traversing, and a stem 6 carrying a thrust head 7 axially traversable with respect to the rod 3, and a circular anastomosing mechanism 8, which is made up of two members. One of the members of said mechanism is located on the mandrel 2 and carries a number of suturing elements adapted to interact with the rod 3 so as to travel together with the latter when establishing circular anastomoses, while the other member is situated on the thrust head 7. The member of the circular anastomosing mechanism 8 that is located on the mandrel 2 comprises two rings 9 and 10 spaced somewhat apart from each other. A plurality of suturing elements are needles 11 equispaced circumferentially between said rings, while some of the needles 11 carry shock absorbers 12. The other member of the circular anastomosing mechanism 8 that is situated on the thrust head 7 is essentially a ring 14 so connected to the latter as to be separable therefrom when anastomosing. Both of the members of the circular anastomosing mechanism 8 are joined together through the needles 11 in the course of circular anastomosing and are left in the colonic lumen until a complete necrosis of the compressed colon portion occurs.
Images(4)
Previous page
Next page
Claims(5)
We claim:
1. A surgical instrument for establishing circular coloanastomoses in a colonic lumen, comprising a cylindrical body having a mandrel at one end, a rod coaxially arranged in said mandrel and having a longitudinal axis, a circular knife attached to said rod, means for moving said rod along its longitudinal axis, a stem having a thrust head axially movable with respect to said rod, means for establishing circular anastomoses comprising two members, one said member located on said mandrel, a plurality of suturing elements attached to said one member adapted to move with the rod during the course of establishing circular anastomoses, the other said member located on the thrust head, wherein a portion of said circular anastomosing means located on said mandrel comprises two rings spaced apart from each other, said plurality of suturing elements equispaced circumferentially between said rings, said suturing elements comprising needles, shock absorbing means accommodated on at least one of said needles, and wherein the other said member of said circular anastomosing means comprises a third ring coupled to the thrust head and adapted to separate therefrom during the course of anastomosing, both of the members of said circular anastomosing means being joined together through said needles in the course of anastomosing and are adapted to remove in the colonic lumen until complete necrosis of a compressed colon portion occurs.
2. The surgical instrument of claim 1, wherein said third ring coupled to the thrust head, comprises a biologically inert polymer material, and at least three of said needles have annular recesses to engage with said third ring, while the thrust head diameter is smaller than the diameter of the circular knife.
3. The surgical instrument of claim 2, wherein the biologically inert polymer material comprises a fluorinated plastic.
4. The surgical instrument of claim 1, also provided with a spool which fits over said stem, said stem having an annular ridge for the spool to rest upon, said annular ridge being spaced apart from the thrust head.
5. The surgical instrument of claim 4, with means to place the spool in the colonic lumen, said means comprising a setting rod, two fixing elements attached to said setting rod, said fitting elements spaced apart from each other and held by a threaded joint, said fixing elements having the shape of two cone frustums arranged opposite each other, said cone frustums facing each other with their lesser bases, with the spool interposed between said fixing elements on the setting rod, one fixing element being mounted at one of the setting rod ends, while the other fixing element being mounted away from the end of the setting rod, said other fixing element having an axial opening adapted to accommodate said spool.
Description
FIELD OF THE INVENTION

The present invention relates to medical equipment and more specifically, to surgical instruments for establishing circular coloanastomoses.

BACKGROUND ART

One prior-art surgical instrument for establishing circular coloanastomoses is known to comprise a cylindrical body having a mandrel at one of its ends and accommodating a coaxially arranged a rod which carries a circular knife held in place thereto, and is provided with a mechanism for its longitudinal traversing, a stem carrying a thrust head, and a mechanism for establishing circular anastomoses, said mechanism consisting of two members, of which one is mounted on the mandrel and the other, on the thrust head. Clearance between the members of the aforesaid mechanism required for applying a purse-string suture is adjustable by a screw-and-nut pair provided on the stem. The mandrel-mounted member of the mechanism for establishing circular anastomoses (hereinafter termed "circular anastomosing mechanism" for the sake of brevity), comprises a cylindrical bush accommodating a splined ring fixed in position thereon so as to define staple slots together with the inner surface of the bush. A cylinder-shaped staple ejector is also accommodated inside the bush. The surface of the thrust head facing the bush carries a plurality of staple recesses equispaced circumferentially thereon so as to correspond to the staple slots and serving to impart the B-shape to the staples in the course of suturing.

The application procedure of the above-discussed known instrument comprises introducing its working components into the lumen of the colon portions being stitched together and fixing the ends of the abovesaid colon portions on the stem of the surgical instrument between the two members of the circular anastomosing mechanism by tightening up preliminarily applied purse-string sutures. Then, both members of the circular anastomosing mechanism are brought together, whereupon the staples are driven out of the slots by the staple ejector and the circular knife longitudinal traversing mechanism, with the result that the staples pierce with their pointed legs the compressed colonic walls to get into the recesses and be bent into the shape of the letter B, thus firmly uniting the ends of the colon portions to be stitched together. Then the circular knife cuts a round hole in the colon within the suture.

Once the suture has been applied, the circular knife longitudinal traversing mechanism is returned to the initial position together with the staple ejector, the bush is disengaged from the thrust head by rotating the nut of the circular knife longitudinal traversing mechanism, and the instrument is withdrawn from the colon operated upon.

The known prior-art instrument discussed above is capable of applying different-diameter circular staple sutures by being provided with a set of changeable staple bushes, ejectors and knives, whereby the instrument is applicable to different-diameter colons whatever the depth of the operative field. However, metal staples left in the bulk of the colonic wall for a prolonged period of time contribute to ingress of infection from the colonic lumen into the bulk of colonic walls being sutured, which makes its way through the holes punctured by the staples. This, in turn, might be cause an inflammatory process resulting in a cicatricial constriction of the anastomotic lumen. In addition, a staple suture involves application of a serous ligature suture along the entire perimeter of the anastomosis so as to prevent propagation of infection and inflammatory process beyond the anastomosis established, which is fraught with peritonitis. Within a late postoperative period, metal staples left in the area of the anastomosis in prolonged contact with the colonic lumen favor the onset of a cicatricial stenosis of the established colostomy. Moreover, in some cases a staple suture fails to provide reliable hemostasis.

DISCLOSURE OF THE INVENTION

The present invention is intended to provide a surgical instrument for establishing coloanastomoses incorporating a circular anastomosing mechanism featuring a constructional arrangement that makes it possible to dispense with the use of a ligature suture, to prevent any foreign body from being left in the area of the anastomosis after the tissues have been inosculated, to ensure against ingress of infection from the colonic lumen, to provide full hemostasis, to render simple and reliable establishing of an anastomosis and to reduce the operating time.

The aforesaid object of the present invention is accomplished in a surgical instrument for establishing circular anastomoses, comprising a cylindrical body having a mandrel at one of its ends and accommodating a coaxially arranged rod which carries a circular knife held in place thereto, and is provided with a mechanism for its longitudinal traversing, a stem carrying a thrust head axially traversable with respect to the rod, a mechanism for establishing circular anastomoses made up of two members of which one member is situated on the mandrel and carries a number of suturing elements adapted to interact with the rod being jointly traversed in the course of establishing circular anastomoses, while the other member of the mechanism is located on the thrust head. According to the present invention, the portion of the circular anastomosing mechanism situated on the mandrel comprises two rings spaced somewhat apart from each other and a plurality of suturing elements equispaced circumferentially between said rings and made essentially as needles, some of which have shock absorbers, whereas the other member of the circular anastomosing mechanism located on the thrust head is in fact a ring coupled to the thrust head with a possibility of being separated therefrom in the course of anastomosing, both of the members of the circular anastomosing mechanism being joined together through said needles in the course of anastomosing and being left in the colonic lumen until complete necrosis of the compressed colon portion occurs.

The constructional arrangement of the circular anastomosing mechanism provides for a firm union of the colonic portions being sutured with an adequate area of serous membranes. Compression of the colonic wall portions through which the needles are to pass defines reliable hemostasis and prevents ingress of infection from the colonic lumen both in between the compressed colonic walls and along the needles, whereby heating proceeds with a minimized inflammatory reaction within the area of the anastomosis and application of ligature serous sutures along the entire perimeter of the anastomosis can be dispensed with. After the circular anastomosing mechanism has been expelled from patient's organism no foreign bodies are left within the area of the anastomosis. Thus, the factor causative of inflammatory reaction in the anastomosis is eliminated. In addition, the intestinal tissues are compressed gradually regardless of their thickness due to the provision of shock absorbers.

It is quite reasonable that the ring provided on the thrust head be made from a biologically inert polymer material and that at least three needles have annular recesses to engage with said ring, while the thrust head diameter be somewhat smaller than the diameter of the circular knife for said head to pass when withdrawing the instrument from the colon through said ring after the latter has been cut through by the circular knife.

This makes it possible to strongly lock the two members of the circular anastomosing mechanism against each other. In addition, the ring is in fact a support for the needles, and being made from a polymer material enables the ring to be cut off by the circular knife for a complete and free withdrawal of every component of the surgical instrument from patient's organism.

Fluorinated plastic may be used as a biologically inert polymer material.

It is expedient that, with a view to preparing the colon distal end for anastomosing, the surgical instrument be provided with a spool fittable over the stem having an annular ridge for the spool to rest upon, said annular ridge being spaced apart from the thrust head for a distance that is required for the purse-string suture to be drawn tight on the colon proximal end against the stem.

This makes it possible to do away with application of a purse-string suture to the colon distal end (which in some cases proves to be impracticable deeply in the small pelvis) thereby rendering the operation more aseptic. In addition, when bringing together both members of the circular anastomosing mechanism, the tissues fixed on the spool are pulled together with the latter into the circular interior, thus forming a cone-shaped space, wherein there are freely accommodated the tissues of the other colon end fixed on the stem of the surgical instrument.

It is quite reasonable that the surgical instrument be provided with a device for positioning the spool in the colonic lumen, said device comprising a setting rod, which carries two fixing elements spaced somewhat apart from each other and held by virtue of a threaded joint, said elements being shaped as two cone frustums arranged against each other and facing each other with their lesser bases, while the spool is interposed between said elements on said setting rod. One of the fixing elements is mounted at one of the setting rod ends, while the other fixing element distant to the end of the setting rod has an axial hollow space for the spool to accommodate.

Practical application of the aforesaid device in the operation enables one to accurately and purposefully fix the distal colon end on the spool when placing a ligature upon said end.

BRIEF DESCRIPTION OF THE DRAWINGS

To promote understanding an exemplary embodiment of the present invention will hereinafter be described in detail with reference to the accompanying drawings, wherein:

FIG. 1 is a general diagrammatic view of a surgical instrument for establishing coloanastomoses, according to the present invention;

FIG. 2 is a scaled-up view of a mechanism for establishing circular anastomoses, shown before the instance of suturing;

FIG. 3 is a longitudinal-section view facing arrow A in FIG. 1;

FIG. 4 is the setting rod and spool assembly;

FIG. 5 is a device for positioning the spool in the rectum, shown when introduced into the rectal lumen;

FIG. 6 illustrates the position of the rectal walls after the thread has been drawn tight and ties up on the spool;

FIG. 7 is a view of the rectum after its having been severed; and

FIG. 8 is a view of the rectum with the stem of the surgical instrument introduced into the spool.

BEST MODE OF CARRYING OUT THE INVENTION

The surgical instrument for establishing circular coloanastomoses incorporates a cylindrical body 1 (FIG. 1) carrying a mandrel 2 at one of its ends. Arranged coaxially in the cylindrical body 1 are a rod 3 carrying a circular knife 4 held in place thereto and having a mechanism 5 for traversing the rod longitudinally and a stem 6 carrying a thrust head 7, which is axially traversable with respect to the rod 3. The surgical instrument is provided with a mechanism 8 (FIG. 2) for establishing circular anastomoses, which is made up of two members. One of the members of the mechanism 8 is situated on the mandrel 2 and comprises two rings 9 and 10 spaced somewhat apart from each other. A plurality of suturing elements are equispaced circumferentially between the rings 9 and 10, said elements being in fact needles 11 locked-in with the ring 9. Some of the needles 11 have shock absorbers 12, while at least three needles 11 have annular recesses 13. The other member of the circular anastomosing mechanism 8 is arranged on the thrust head 7 and is essentially a ring 14 made from a biologically inert polymer material, which enables said ring 14 to be separated from the thrust head 7 during inosculation by being cut through by the knife 4. Used as a biologically inert polymer material may be fluorinated plastic (fluoroplast). Both of the members of the circular anastomosing mechanism 8 are joined together through the needles 11 when placing circular anastomoses, and are left in the colonic lumen until the compressed necrotic colon portion is cast off. The thrust head 7 is shaped as a nut having a diameter somewhat smaller than the diameter of the circular knife 4, so that the thrust head 7 be free to pass through the plastics ring 14 after its having been cut through by the circular knife for the surgical instrument to be withdrawn from the colon operated upon.

A nut 16 (FIG. 1) is held to the end face of the cylindrical body 1 by screws 15 (FIG. 3), said nut being adapted to engage the threaded portion of a stem 17 and cause the latter to traverse along the cylindrical body 1, with the result that both of the members of the circular anastomosing mechanism 8 (FIG. 1) can be either brought together or set apart.

The mechanism 5 (FIG. 1) for longitudinal traversing of the circular knife 4 comprises a stationary handle 18 and an articulately movable handle 19, both of them being fixed in place on arms 20 of the cylindrical body 1. The articulately movable handle 19 carries a swivel lock 21 adapted to interact with a stop 22 held in position to the stationary handle 18, the angle of swivel of the lock 21 being restricted by pins 23.

A shorter working arm 24 of the movable handle 19 enters into the interior of the cylindrical body 1 through an opening 25 so as to straddle the flat side surfaces of the rod 3. Shoulders 26 are provided in the rod 3, serving as stops for the arm 24.

In order to prepare the colon distal end for anastomosing, the surgical instrument is provided with a spool 27 (FIG. 4) fittable over the stem 6, which has an annular ridge 28 for the spool 27 to rest upon, said annular ridge 28 being spaced apart from the thrust head 7 for a distance that is long enough for the purse-string suture applied to the colon distal end to be drawn tight on the stem 6.

The surgical instrument has a device 29 (FIG. 5) for the spool 27 to set in position in the colonic lumen, said device 29 comprising a setting rod 30, which carries two fixing elements 31 and 32 spaced somewhat apart from each other and held by virtue of a threaded joint. The fixing elements 31 and 32 are shaped as oppositely arranged cone frustums facing each other with their lesser bases, while the spool 27 is interposed therebetween. The fixing element 31 is located at one end of the setting rod 30, while the fixing element 32 distant to the end of the setting rod 30 has an axial hollow space 33 for the spool 27 to accommodate.

The herein-proposed surgical instrument for establishing circular coloanastomoses is applicable for anastomosing by the end-to-end and end-to-side techniques, as well as for inosculating various colon segments or establishing entercolostomies. Considered hereinbelow is an exemplary anastomosing operation by the end-to-end technique.

In order to fix the end of the severed rectum so as to establish an end-to-end rectocolostomy prior to ablating the pathologically affected rectal segment, the spool 27 (FIG. 6) is introduced into the rectum via the anus using the device 29. Having brought the spool 27 along with the device 29 short of an affected rectal segment 34, one must bind up the spool together with an unaffected rectal segment 35, using a thread 36, whereupon the thread is tied up into a knot at a flange 37 of the spool 27. Then one must back out the fixing element 32 using the setting rod 30 and next bring the latter together with the fixing element 32 out of the rectal lumen, after which one must tension the rectum and sever it at the flange 37 (FIG. 7) of the spool 27. Thereupon the affected portion of the rectum is removed together with the fixing element 31 accommodated therein. Next the stem 6 (FIG. 8) carrying the plastic ring 14 and the thrust head 7 is introduced into the bore of the spool 27 until the flange 37 of the latter rests against the annular ridge 28. Thus, the end of the severed rectum is fixed on the stem 6 of the surgical instrument in a quick and simple way. Further the surgical instrument is introduced into the anus 39 along the stem 6 and is fixed exactly in the working position on the stem 6 by the annular ridge 28, the spool 27 and a nut 40 (FIG. 1). The distance from the annular ridge 28 to the plastic ring 14 is large enough to freely fix the proximal segment of the rectum on the stem 6 under the thrust head 7 and the plastic ring 14. This done one must rotate the nut 16 to bring together the both members of the circular anastomosing mechanism 8 until they assume the working position, whereupon one must turn the handle 38 of the lock 21 so as to disengage it from the stop 22 and remove as far as possible therefrom, and must press the movable handle 19. As a result, the shorter actuating arm 24 of the handle presses the shoulders 26 of the rod 3, thus causing the latter to traverse together with the circular knife held thereto. The knife 4, in turn, moves the ring 9 together with the needles 11 fixed thereon. Thus, the ring 9 with the needles 11 finally locks together both of the members of the circular anastomosing mechanism 8, while some of the needles 11, which have the annular recesses 13 pass through the plastic ring 14 to tightly press the latter against the ring 10 and fix it thereon.

The circular knife cuts off the surplus of the intestinal walls, which are then removed when withdrawing the surgical instrument together with the thrust head 7 locked thereto, through the anal orifice. Removed together with the thrust head 7 are also the pieces of the plastic ring 14 cut off by the circular knife 4.

The circular anastomosing mechanism 8 is left in the rectal lumen until the necrotized portion of the rectum is rejected; it is removed from patient's organism by natural way 7 to 10 days after the operation.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2235530 *Mar 11, 1939Mar 18, 1941Mercer Claude HSecuring means
US3254650 *Mar 19, 1962Jun 7, 1966Michael B CollitoSurgical anastomosis methods and devices
US3552626 *Apr 4, 1968Jan 5, 1971Anatoly Nikolaevich OzhgikhinInstrument for circular suturing of hollow body organs
US4060089 *Sep 3, 1975Nov 29, 1977United States Surgical CorporationSurgical fastening method and device therefor
DE357306C *Aug 21, 1922M Favarger DrZusammensteckbarer Knopf mit UEberleitungskanal zum Einsetzen zwischen die miteinander zu verbindenden Darmstuecke bei Darmoperationen
SU264612A1 * Title not available
SU571254A2 * Title not available
Non-Patent Citations
Reference
1Collection of papers "Isrusstuennye organi i bisupronliemyl Protezy", published 1972, Znanie publishers (Moscow) V.I. Shumakov Isrusstennye, Organy, p. 16.
2 *Collection of papers Isrusstuennye organi i bisupronliemyl Protezy , published 1972, Znanie publishers (Moscow) V.I. Shumakov Isrusstennye, Organy, p. 16.
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US4592354 *Oct 11, 1983Jun 3, 1986Senmed, Inc.Tissue retention spool for intraluminal anastomotic surgical stapling instrument and methods
US4681108 *Feb 13, 1985Jul 21, 1987Riccardo RosatiCircular mechanical anastomotic gun
US4703887 *Jan 28, 1985Nov 3, 1987Ethicon, Inc.Collapsible purse string aid for use with intraluminal stapling device
US4752024 *Oct 17, 1986Jun 21, 1988Green David TSurgical fastener and surgical stapling apparatus
US4893622 *Mar 31, 1988Jan 16, 1990United States Surgical CorporationMethod of stapling tubular body organs
US4907591 *Mar 29, 1988Mar 13, 1990Pfizer Hospital Products Group, Inc.Surgical instrument for establishing compression anastomosis
US4957499 *Jun 27, 1988Sep 18, 1990Lipatov Viktor ASurgical suturing instrument
US4964863 *May 26, 1988Oct 23, 1990Moskovsky Gorodskoi Nauchno-Issledovatelsky Institut Skoroi Pomoschi Imeni N.V. SklifosovskogoDevice for establishing esophagoenterostomies
US5119983 *May 26, 1987Jun 9, 1992United States Surgical CorporationSurgical stapler apparatus
US5158222 *May 17, 1991Oct 27, 1992United States Surgical Corp.Surgical stapler apparatus
US5197648 *Dec 3, 1991Mar 30, 1993Gingold Bruce SSurgical stapling apparatus
US5197649 *Oct 29, 1991Mar 30, 1993The Trustees Of Columbia University In The City Of New YorkGastrointestinal endoscoptic stapler
US5222963 *Jan 17, 1991Jun 29, 1993Ethicon, Inc.Absorbable anastomotic tissue fastener
US5261920 *Aug 21, 1992Nov 16, 1993Ethicon, Inc.Anvil bushing for circular stapler
US5273519 *Oct 22, 1991Dec 28, 1993Tibor KorosBongeur surgical instrument
US5285944 *Dec 6, 1990Feb 15, 1994United States Surgical CorporationSurgical stapler apparatus
US5309927 *Oct 22, 1992May 10, 1994Ethicon, Inc.Circular stapler tissue retention spring method
US5314435 *May 19, 1992May 24, 1994United States Surgical CorporationSurgical apparatus
US5344059 *Sep 23, 1992Sep 6, 1994United States Surgical CorporationSurgical apparatus and anvil delivery system therefor
US5346501 *Feb 5, 1993Sep 13, 1994Ethicon, Inc.Laparoscopic absorbable anastomosic fastener and means for applying
US5368215 *Sep 8, 1992Nov 29, 1994United States Surgical CorporationSurgical apparatus and detachable anvil rod therefor
US5392979 *Nov 12, 1993Feb 28, 1995United States Surgical CorporationSurgical stapler apparatus
US5411508 *Mar 30, 1993May 2, 1995The Trustees Of Columbia University In The City Of New YorkGastrointestinal approximating and tissue attaching device
US5443198 *Jul 7, 1994Aug 22, 1995United States Surgical CorporationSurgical fastener applying apparatus
US5474223 *Jul 5, 1994Dec 12, 1995United States Surgical CorporationSurgical fastener applying apparatus
US5588579 *Nov 15, 1995Dec 31, 1996United States Surgical CorporationAnvil for circular stapler
US5628762 *Jan 17, 1996May 13, 1997Al-Tameem; MoshinMethod of using a device for excision of a fistula
US5639008 *Feb 9, 1996Jun 17, 1997The United States Surgical CorporationAnvil for circular stapler
US5643305 *Nov 18, 1994Jul 1, 1997Al-Tameem; MoshinDevice for excision of a fistula
US5718360 *Nov 17, 1994Feb 17, 1998United States Surgical CorporationSurgical apparatus and detachable anvil rod therefor
US5758814 *May 27, 1997Jun 2, 1998United States Surgical CorporationAnvil for circular stapler
US5915616 *Oct 10, 1997Jun 29, 1999United States Surgical CorporationSurgical fastener applying apparatus
US6053390 *May 10, 1999Apr 25, 2000United States SurgicalAnvil for surgical stapler
US6315184Jun 2, 1999Nov 13, 2001Powermed, Inc.Stapling device for use with an electromechanical driver device for use with anastomosing, stapling, and resecting instruments
US6443973Jun 2, 1999Sep 3, 2002Power Medical Interventions, Inc.Electromechanical driver device for use with anastomosing, stapling, and resecting instruments
US6488197Feb 22, 2000Dec 3, 2002Power Medical Interventions, Inc.Fluid delivery device for use with anastomosing resecting and stapling instruments
US6491201Feb 22, 2000Dec 10, 2002Power Medical Interventions, Inc.Fluid delivery mechanism for use with anastomosing, stapling, and resecting instruments
US6503259 *Dec 27, 2000Jan 7, 2003Ethicon, Inc.Expandable anastomotic device
US6505768Jun 4, 2001Jan 14, 2003Power Medical Interventions, Inc.Expanding parallel jaw device for use with an electromechanical driver device
US6517565Feb 22, 2000Feb 11, 2003Power Medical Interventions, Inc.Carriage assembly for controlling a steering wire steering mechanism within a flexible shaft
US6533157Feb 22, 2000Mar 18, 2003Power Medical Interventions, Inc.Tissue stapling attachment for use with an electromechanical driver device
US6681979Nov 25, 2002Jan 27, 2004Power Medical Interventions, Inc.Fluid delivery device for use with anastomosing stapling, and resecting instruments
US6698643Jan 13, 2003Mar 2, 2004Power Medical Interventions, Inc.Expanding parallel jaw device for use with an electromechanical driver device
US6716230Nov 21, 2001Apr 6, 2004Power Medical Interventions, Inc.Vessel and lumen expander attachment for use with an electromechanical driver device
US6716233Feb 22, 2000Apr 6, 2004Power Medical Interventions, Inc.Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US6793652Nov 28, 2000Sep 21, 2004Power Medical Interventions, Inc.Electro-mechanical surgical device
US6843403Nov 13, 2001Jan 18, 2005Power Medical Interventions, Inc.Surgical clamping, cutting and stapling device
US6846307Sep 27, 2002Jan 25, 2005Power Medical Interventions, Inc.Electro-mechanical surgical device
US6846308Sep 26, 2002Jan 25, 2005Power Medical Interventions, Inc.Electro-mechanical surgical device
US6846309Sep 26, 2002Jan 25, 2005Power Medical Interventions, Inc.Electro-mechanical surgical device
US6849071Sep 26, 2002Feb 1, 2005Power Medical Interventions, Inc.Electro-mechanical surgical device
US6945444Apr 3, 2002Sep 20, 2005Tyco Healthcare Group, LpSurgical stapling device for performing circular anastomoses
US6957758Oct 4, 2002Oct 25, 2005Tyco Healthcare Group, LpTilt top anvil for a surgical fastener device
US6959851Jul 16, 2004Nov 1, 2005Tyco Healthcare Group LpSurgical stapling device with tissue tensioner
US6981941Apr 17, 2001Jan 3, 2006Power Medical InterventionsElectro-mechanical surgical device
US7032798Jun 22, 2001Apr 25, 2006Power Medical Interventions, Inc.Electro-mechanical surgical device
US7077856Jan 20, 2004Jul 18, 2006Power Medical Interventions, Inc.Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US7114642Jan 20, 2004Oct 3, 2006Power Medical Interventions, Inc.Expanding parallel jaw device for use with an electromechanical driver device
US7168604Jun 21, 2004Jan 30, 2007Tyco Healthcare Group LpSurgical stapling device
US7195142May 1, 2006Mar 27, 2007Tyco Healthcare Group LpEnd-to-end anastomosis instrument and method for performing same
US7234624Aug 22, 2005Jun 26, 2007Tyco Healthcare Group LpSurgical stapling device for performing circular anastomoses
US7303106Oct 6, 2003Dec 4, 2007Tyco Healthcare Group LpSurgical stapling device with visual indicator
US7325713Jun 9, 2005Feb 5, 2008Tyco Healthcare Group LpTilt top anvil for a surgical fastener device
US7364060Oct 18, 2004Apr 29, 2008Tyco Healthcare Group LpSurgical stapling device with tiltable anvil head
US7399305Jul 28, 2006Jul 15, 2008Tyco Healthcare Group LpSurgical stapling device with tissue tensioner
US7422137Dec 13, 2005Sep 9, 2008Tyco Healthcare Group LpAnastomosis instrument and method for performing same
US7431191Apr 20, 2007Oct 7, 2008Tyco Healthcare Group LpSurgical stapling device with tiltable anvil head
US7494038Mar 16, 2005Feb 24, 2009Tyco Healthcare Group LpAnvil assembly with improved cut ring
US7516877May 18, 2007Apr 14, 2009Tyco Healthcare Group LpTilt top anvil for a surgical fastener device
US7527185Jul 12, 2006May 5, 2009Niti Surgical Solutions Ltd.Compression anastomosis ring assembly and applicator for use therewith
US7537602Oct 2, 2006May 26, 2009Power Medical Interventions, Inc.Expanding parallel jaw device for use with an electromechanical driver device
US7546940Oct 29, 2007Jun 16, 2009Tyco Healthcare Group LpPivoting anvil assembly for surgical stapling device
US7556186Apr 14, 2008Jul 7, 2009Tyco Healthcare Group LpSurgical stapling device having trigger lock and associated lockout mechanism
US7635385May 5, 2006Dec 22, 2009Keith MillimanAnastomosis instrument and method for performing same
US7695485Nov 30, 2001Apr 13, 2010Power Medical Interventions, LlcSurgical device
US7743958May 5, 2006Jun 29, 2010Tyco Healthcare Group LpEnd-to-end anastomosis instrument and method for performing same
US7743960Jun 11, 2003Jun 29, 2010Power Medical Interventions, LlcSurgical device
US7758613Jul 17, 2006Jul 20, 2010Power Medical Interventions, LlcElectromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US7802712Mar 20, 2009Sep 28, 2010Tyco Healthcare Group, LpSurgical stapling device
US7845538May 26, 2009Dec 7, 2010Power Medical Interventions, LlcExpanding parallel jaw device for use with an electromechanical driver device
US7857187Jun 18, 2009Dec 28, 2010Tyco Healthcare Group LpSurgical stapler with tiltable anvil assembly
US7931183Jun 1, 2010Apr 26, 2011Tyco Healthcare Group LpEnd-to-end anastomosis instrument and method for performing same
US7942302Jul 11, 2008May 17, 2011Tyco Healthcare Group LpSurgical stapling device with coated knife blade
US7951071Mar 15, 2002May 31, 2011Tyco Healthcare Group LpMoisture-detecting shaft for use with an electro-mechanical surgical device
US7975895Apr 30, 2010Jul 12, 2011Tyco Healthcare Group L.P.Tissue tensioner assembly and approximation mechanism for surgical stapling device
US8011554Jan 6, 2009Sep 6, 2011Tyco Healthcare Group, LpRaised boss for staple guide
US8016855Mar 8, 2002Sep 13, 2011Tyco Healthcare Group LpSurgical device
US8016858 *Jul 19, 2010Sep 13, 2011Tyco Healthcare Group IpElectromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US8021373Mar 30, 2010Sep 20, 2011Tyco Healthcare Group LpSurgical device
US8025198Sep 4, 2008Sep 27, 2011Tyco Healthcare Group LpAnastomosis instrument and method for performing same
US8025199Feb 23, 2004Sep 27, 2011Tyco Healthcare Group LpSurgical cutting and stapling device
US8056791Dec 6, 2010Nov 15, 2011Tyco Healthcare Group LpExpanding parallel jaw device for use with an electromechanical driver device
US8070037 *Mar 5, 2010Dec 6, 2011Tyco Healthcare Group, LpCircular stapler for hemorrhoid operations
US8109427Apr 15, 2011Feb 7, 2012Tyco Healthcare Group LpEnd-to end anastomosis instrument and method for performing same
US8118208Oct 3, 2011Feb 21, 2012Tyco Healthcare Group LpExpanding parallel jaw device for use with an electromechanical driver device
US8123102Sep 8, 2011Feb 28, 2012Tyco Healthcare Group LpAnastomosis instrument and method for performing same
US8123103Nov 29, 2010Feb 28, 2012Tyco Healthcare Group LpAdaptor for anvil delivery
US8141763 *Mar 27, 2007Mar 27, 2012Tyco Healthcare Group LpAnvil assembly with improved cut ring
US8146790 *May 17, 2010Apr 3, 2012Tyco Healthcare Group LpSurgical instrument with safety mechanism
US8181838Aug 31, 2009May 22, 2012Tyco Healthcare Group LpSurgical stapling device
US8181840Mar 16, 2005May 22, 2012Tyco Healthcare Group LpTissue tensioner assembly and approximation mechanism for surgical stapling device
US8186559Jan 18, 2012May 29, 2012Tyco Healthcare Group LpExpanding parallel jaw device for use with an electromechanical driver device
US8205782Jul 12, 2007Jun 26, 2012Niti Surgical Solutions Ltd.Compression assemblies and applicators for use therewith
US8231042Oct 20, 2009Jul 31, 2012Tyco Healthcare Group LpSurgical stapler
US8267301Jun 21, 2010Sep 18, 2012Tyco Healthcare Group LpSurgical stapler
US8272555 *Mar 7, 2007Sep 25, 2012Tyco Healthcare Group LpStapler for mucosectomy
US8281974Jan 7, 2010Oct 9, 2012Tyco Healthcare, Group LPSurgical stapler with suture locator
US8317075Aug 1, 2011Nov 27, 2012Covidien LpRaised boss for staple guide
US8322590Oct 6, 2010Dec 4, 2012Covidien LpSurgical stapling instrument
US8343185May 2, 2012Jan 1, 2013Covidien LpSurgical stapling device
US8348122Sep 5, 2006Jan 8, 2013Tyco Healthcare Group LpSurgical stapling device
US8357144Feb 1, 2005Jan 22, 2013Covidien, LPElectro-mechanical surgical device
US8360295May 21, 2012Jan 29, 2013Covidien LpSurgical stapling device
US8365974Jan 26, 2012Feb 5, 2013Covidien LpSurgical stapling device
US8403942Jan 25, 2012Mar 26, 2013Covidien LpAnvil delivery device accessory
US8413872Oct 7, 2010Apr 9, 2013Covidien LpSurgical fastening apparatus
US8424535Jul 5, 2012Apr 23, 2013Covidien LpCircular surgical stapler with mating anvil and shell assembly
US8430292Oct 7, 2010Apr 30, 2013Covidien LpSurgical fastening apparatus
US8435203 *Jun 20, 2007May 7, 2013Covidien LpGastric restrictor assembly and method of use
US8453911Aug 18, 2012Jun 4, 2013Covidien LpSurgical stapler
US8453913Jan 16, 2010Jun 4, 2013Covidien LpAnvil for surgical stapler
US8459523Apr 26, 2012Jun 11, 2013Covidien LpExpanding parallel jaw device for use with an electromechanical driver device
US8464924May 16, 2007Jun 18, 2013Covidien LpSurgical stapling device for performing circular anastomoses
US8512359Aug 11, 2011Aug 20, 2013Covidien LpSurgical device
US8518074Aug 25, 2011Aug 27, 2013Covidien LpSurgical device
US8540132May 16, 2006Sep 24, 2013Covidien LpTilt anvil assembly
US8579937Jul 31, 2003Nov 12, 2013Covidien LpTool member cover and cover deployment device
US8590763Jan 4, 2013Nov 26, 2013Covidien LpSurgical stapling device
US8623035 *May 8, 2008Jan 7, 2014University Of South FloridaMethods for resection of a luminal structure
US8628467Apr 25, 2011Jan 14, 2014Covidien LpMoisture-detecting shaft for use with an electro-mechanical surgical device
US8684248Feb 29, 2012Apr 1, 2014Covidien LpSurgical instrument with safety mechanism
US8684251Aug 24, 2012Apr 1, 2014Covidien AgStapler for mucosectomy
US8684252Nov 2, 2012Apr 1, 2014Covidien LpSurgical stapling instrument
US8690913Jul 27, 2011Apr 8, 2014Covidien LpElectromechanical drive and remote surgical instrument attachment having computer assisted control capabilities
US8708212Oct 18, 2011Apr 29, 2014Covidien LpTilt top anvil with torsion spring
US8740932Aug 12, 2013Jun 3, 2014Covidien LpSurgical device
US20080319470 *Jun 20, 2007Dec 25, 2008Viola Frank JGastric restrictor assembly and method of use
US20090005637 *Jun 27, 2008Jan 1, 2009Scimed Life Systems, Inc.Method and Apparatus for Measuring and Controlling Blade Depth of a Tissue Cutting Apparatus in an Endoscopic Catheter
US20100213239 *Mar 7, 2007Aug 26, 2010Carlo RebuffatStapler for mucosectomy
EP0495673A1 *Jan 17, 1992Jul 22, 1992Ethicon Inc.Pull-through circular anastomosic intraluminal stapler with fastener means
EP0554990A1 *Jan 22, 1993Aug 11, 1993Andreas G. TzakisApparatus for anastomosis
EP0585069A1 *Aug 20, 1993Mar 2, 1994Ethicon Inc.Anvil bushing for circular stapler
WO1989000406A1 *Jan 28, 1988Jan 26, 1989Guskov Igor ASurgical suturing apparatus
WO2010063313A1 *Dec 2, 2008Jun 10, 2010Ethicon Endo-Surgery, Inc.A device and method for hollow organ resection and closure
Classifications
U.S. Classification606/153, 606/171, 227/19
International ClassificationA61B17/115
Cooperative ClassificationA61B17/1155, A61B17/115
European ClassificationA61B17/115
Legal Events
DateCodeEventDescription
Dec 22, 1992FPExpired due to failure to pay maintenance fee
Effective date: 19921018
Oct 18, 1992LAPSLapse for failure to pay maintenance fees
May 20, 1992REMIMaintenance fee reminder mailed
Apr 13, 1988FPAYFee payment
Year of fee payment: 4